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HomeMy WebLinkAbout75A - PH-HOOKAH PARLORSREQUEST FOR COUNCIL ACTION CITY COUNCIL MEETING DATE: FEBRUARY 4, 2008 TITLE: PUBLIC HEARING - ZONING ORDINANCE AMENDMENT NO. 2007-06 AND ORDINANCE AMENDMENT NO. 2008-01 TO AMEND CHAPTERS 41 AND 18 OF THE SANTA ANA MUNICIPAL CODE TO PROHIBIT HOOKAH PARLORS IN THE CITY l i ~ Vl•t~% C,~ - CITY MANAGER RECOMMENDED ACTION CLERK OF COUNCIL USE ONLY: APPROVED ^ As Recommended ^ As Amended ^ Ordinance on 151 Reading ^ Ordinance on 2nd Reading ^ Implementing Resolution ^ Set Public Hearing For_ CONTINUED TO FILE NUMBER 1. Adopt an ordinance approving Zoning Ordinance Amendment No. 2007- 06. 2. Adopt an ordinance approving Ordinance Amendment No. 2008-01. PLANNING COMMISSION ACTION On January 14, 2008, the Planning Commission recommended that the City Council adopt an ordinance approving Zoning Ordinance Amendment No. 2007-06 and adopt an ordinance approving Ordinance Amendment No. 2008-01 by a vote of 3:1 (Mill opposed; Betancourt, Gartner, Leo absent) to amend Chapters 41 and 18 of the Santa Ana Municipal Code to prohibit Hookah Parlors in the City. The Planning Commission made no changes to the modifications outlined in the attached staff report (Exhibit A). Additionally, an article by Kamlesh Asotra, Ph.D., published by Tobacco- Related Disease Research Program (TRDRP) in its August 2005 issue is attached (Exhibit B), and highlights the concerns of public health professionals with the detrimental health effects of hookah smoking and the myths perpetuating hookah smoking among teens and college students. Another universal concern is the close proximity of combustible materials to flammable textiles as noted in the experience of Fire Chief Doug Angrove in Victoria, British Columbia, where two university students died in an early morning fire caused by a smoldering charcoal ember that fell from a tipped over hookah pipe (Exhibit C). 75A-1 Zoning Ordinance Amendment No. 2007-06 Ordinance Amendment No. 2008-01 February 4, 2008 Page 2 FISCAL IMPACT There is no fiscal impact associated with this action. Jay M. Trevino Executive Director Planning & Building Agency LP:rb lp/reports/zoa07-06 Hookah.cc 75A-2 REQUEST FOR Planning Commission Action PLANNING COMMISSION MEETING DATE: JANUARY 14, 2008 TITLE: PUBLIC HEARING - ZONING ORDINANCE AMENDMENT NO. 2007-06 AND ORDINANCE AMENDMENT NO. 2008-01 TO AMEND CHAPTERS 41 AND 18 OF THE SANTA ANA MUNICIPAL CODE TO PROHIBIT HOOKAH PARLORS IN THE CITY Prepared by Lynnette Perry Executive Director RECOMMENDED ACTION Recommend that the City Council: PLANNING COMMISSION SECRETARY APPROVED ^ As Recommended ^ As Amended ^ Set Public Hearing For DENIED ^ Applicant's Request ^ Staff Recommendation CONTINUED TO C~`^~'-' Planning M ger 1. Adopt an ordinance approving Zoning Ordinance Amendment No. 2007- 06. 2. Adopt an ordinance approving Ordinance Amendment No. 2008-O1. DISCUSSION Background On December 6, 2007 following a discussion of the issues, the City Council Development Committee recommended an ordinance banning hookah parlors be considered by the City Council. Based upon the General Plan policies direction to promote public health and safety in the community and to discourage the intrusion of incompatible uses, staff recommends the approval of Zoning Ordinance Amendment No. 2007-06 and Ordinance Amendment No. 2008-01 to prohibit the establishment of Hookah Parlors in Santa Ana. Provisions of the General Plan and Chapter 41 of the Santa Ana Municipal Code do not specifically identify hookah parlors as a land use or designate zoning districts throughout the City where this use is permitted. Since February 21, 2006, the City Council has had a moratorium on new hookah parlors; generally such moratoriums cannot exceed two years. A "hookah parlor" is generally a facility or location whose business EXHIBIT A 75A-3 Zoning Ordinance Amendment No. 2007-06 Ordinance Amendment No. 2008-01 January 14, 2008 Page 2 operation is denoted by the smoking of flavored or unflavored tobacco or other substances through one or more pipes (commonly known as a hookah, waterpipe, shisha or narghile) designed with a tube passing through an urn of water that cools the smoke as it is drawn through it, including but not limited to, establishments known variously as hookah bars, hookah lounges or hookah cafes. Numerous health and medical research organizations have published articles concerning the risks and addictive nature associated with smoking hookah tobacco. The World Health Organization (WHO) warns about the common misconception that inhaling tobacco through water reduces the risks associated with cigarette smoking as unfounded (Exhibit 1). A person can inhale more than 100 times more smoke in one hookah session than with a single cigarette. According to Dr. Christopher Loffredo, PhD., Director of the Cancer Genetics and Epidemiology program at Georgetown University Medical Center, a person can inhale "high levels of toxic compounds including high levels of carbon monoxide, metals and cancer-causing chemicals" creating serious health risk for the smoker and non-smokers as well. Dr. Loffredo expressed another concern in that hookah use may represent a loophole around city and state laws banning smoking in public places. If hookah parlors are left unregulated they may pose a threat to public interest, health and safety. Many hookah bar owners claim they are tobacco retailers (like a cigar shop) and current State law does not clearly repudiate this claim. This allows tobacco smoking inside establishments where people work, eat and drink. Hookah is not a safe alternative to smoking tobacco. Smoking hookah pipes has been reported to cause oral, esophageal and lung cancer, as well as heart disease, chronic bronchitis and of course, nicotine addiction. The City Council approved an ordinance in November 2006 to require the licensure of tobacco retailers to protect the health of the City's youth by reducing access to tobacco products. The City Council further has expressed interest in discouraging resident's exposure to tobacco products through the approval of the hookah parlor moratorium. Hookah parlors both in other parts of Orange County and nationally, have generated hundreds of police service calls for public loitering, public drinking and intoxication, possession of illegal weapons and noise. These calls included complaints about loud music and DJ's at party and rave events at these establishments, open business doors that allow music and 7 5A-4 Zoning Ordinance Amendment No. 2007-06 Ordinance Amendment No. 2008-01 January 14, 2008 Page 3 smoke to emanate into neighborhoods, unregulated hours of operation, parking impacts and underage smoking and alcohol usage. Fire Officials have also expressed concerns with the storage, transfer and use of heated coals within a building, charcoal braziers outside buildings on sidewalks or adjacent to entry and/or rear exit doors and the disposal of used coals. Locally, an Orange County Register article (November 10, 2005) noted that in two and one-half years, the Anaheim Police Department had responded to 413 incidents relating to hookah parlors. These issues have prompted nations, states, counties and cities to establish regulations and/or ban the establishment of hookah parlors. Jurisdictions such as France, Germany, Turkey, United Kingdom, Calgary, Alberta, CN, New York, NY, State of Washington and Dublin, CA have banned hookah businesses. In California, several cities, including but not limited to Anaheim, Calabasas, Fullerton, Garden Grove, La Habra, Long Beach, Pasadena and San Diego have adopted moratoriums or development restrictions to regulate hookah parlors (Exhibit 2). Staff Analysis Due to impacts experienced by other cities with unregulated hookah parlors and the health and safety risks involved in hookah use, it is of particular concern that hookah parlors are increasingly found near college campuses and entertainment destinations frequented by teens and young adults. The city may experience an increase in interest to establish hookah parlors given Santa Ana's median age of 26.5 (in 2000). Previously, the city had two illegal hookah parlors operating without approved occupancy and recently staff received two specific inquiries concerning opening hookah related businesses within the City. The Community's identity and long range vision is reflected in the General Plan's Land Use Element goals and policies. Santa Ana has developed into a compact urban environment with approximately 58.7 percent of the city's 27.3 square miles devoted to residential uses. Surrounding the neighborhoods are both neighborhood serving and arterial commercial development. The General Plan land use policies are intended to support the preservation of the neighborhoods, discourage the intrusion of incompatible uses and promote public health and safety. These policies are balanced by encouraging commercial development that creates a safe and attractive business environment and discouraging incompatible commercial intrusion into industrial areas. Zoning is the vehicle to implement these 75A-5 Zoning Ordinance Amendment No. 2007-06 Ordinance Amendment No. 2008-O1 January 14, 2008 Page 4 goals and policies. Zoning regulations permit specific types of compatible land uses and uses that have the potential to negatively impact either adjacent neighborhoods or surrounding business require a conditional use permit in commercial and industrial zoning districts. Hookah parlors present the potential to expose neighboring business and residences to health and safety impacts. The California Air Resources Board classified secondhand smoke as a toxic pollutant that contributes to death and illnesses among non-smokers. Since many of the commercial buildings in the city are historic or constructed of flammable materials and share common walls with other structures, secondhand smoke pollution and the introduction of heated charcoal within or directly outside the structure creates fire safety as well as toxic fumes impacts not only for the employees but adjacent businesses and residences. However, without regulating hookah parlors the city's commercial and industrial zones are vulnerable to the same impacts as residential under the zoning classification "retail and service uses" in the Santa Ana Municipal Code Section 41-144 which may allow hookah parlors under this broad definition. Staff has determined that Hookah Parlors are not in the best interest of public health and safety nor compatible with or supportive of surrounding land uses in any zone. This analysis is based on the experiences of other jurisdictions, and potential detrimental health effects to Santa Ana's adjacent businesses, neighborhoods, and other sensitive land uses. CEQA Compliance In accordance with the California Environmental Quality Act, the recommended action is exempt from further review. A Notice of Exemption will be filed for this project. ~~ Lynnette Perry Associate Planner ~~r~--~~ Verny Carvajal Senior Planner LP jm lp/reports/zoa07-06 Hookah.pc 75A-6 ~_ 7B°~; The World Health Organization (WHO) was established in 1948 as a specialized agency of the United Nations serving as the directing and coordinating authority for international health matters and public health. One of WHO's constitutional functions is to provide objective and reliable information and advice in the field of human health, a responsibility that it fulfils in part through its extensive programme of publications. The Organization seeks through its publications to support national health strategies and address the most pressing public health concerns of populations azound the world. To respond to the needs of Member States at all levels of development, WHO publishes practical manuals, handbooks and training material for specific categories of health workers; internationally applicable guidelines and standards; reviews and analyses of health policies, programmes and reseazch; and state-of--the-art consensus reports that offer technical advice and recommendations for decision-makers. These books aze closely tied to the Organization's priority activities, encompassing disease prevention and control, the development of equitable health systems based on primary health Gaze, and health promotion for individuals and communities. Progress towards better health for all also demands the global dissemination and exchange of information that draws on the knowledge and experience of all WHO's Member countries and the collaboration of world leaders in public health and the biomedical sciences. To ensure the widest possible availability of authoritative information and guidance on health matters, WHO secures the broad international distribution of its publications and encourages their translation and adaptation. By helping to promote and protect health and prevent and control disease throughout the world, WHO's books contribute to achieving the Organization's principal objective -- the attainment by all people of the highest possible level of health. In pursuit of this end, the Organization has vested the Director-General with the mandate to establish study groups to tackle scientific issues where WHO is expected to formulate policies to assist governments in formulating national regulations that have public health significance. The following advisory note is the result of the deliberations of one of the study groups so created, the WHO Study Group on Tobacco Product Regulation. 75A-8 WHO Study Group on Tobacco Product Regulation Advisory Note: Waterpipe Tobacco Smoking: Health Effects, Research Needs and Recommended Actions by Regulators Purpose of advisory This advisory note, formulated by the WHO Study Group on Tobacco Product Regulation (TobReg), addresses the growing concerns about the increasing prevalence and potential health effects of tobacco smoking using waterpipes, also called "waterpipe tobacco smoking". The purposes of the advisory are to provide guidance to WHO and its Member States, to inform regulatory agencies in their efforts to implement the provisions of the WHO Framework Convention on Tobacco Control concerning education and communications, and to educate consumers about the risks of waterpipe smoking. The advisory also provides guidance to researchers and research agencies interested in facilitating a more thorough understanding of the health effects of tobacco waterpipe smoking, and to those engaged in developing tobacco smoking prevention and cessation programmes so that such programmes accommodate the unique aspects of waterpipe smoking. Background and history Waterpipes have been used to smoke tobacco and other substances by the indigenous peoples of Africa and Asia for at least four centuries (1). According to one historical account (1), a waterpipe was invented in India by a physician during the reign of Emperor Akbaz (who ruled from 1556 to1605) as a purportedly less harmful method of tobacco use. The physician Hakim Abul Fath suggested that tobacco "smoke should be first passed through a small receptacle of water so that it would be rendered hazmless" (2). Thus, a widespread but unsubstantiated belief held by many waterpipe users today -that the practice is relatively safe - is as old as the waterpipe itself (3). Mazketing tools associated with waterpipes and waterpipe tobacco may reinforce this unsubstantiated belief (4). For example, the label of a popular waterpipe tobacco brand sold in South-West Asia and North America states "0.5% nicotine and 0% tar". 75A-9 Description of waterpipes and waterpipe smoking Generally, waterpipes have a head, body, water bowl, and hose (see figure). Holes in the bottom of the head allow smoke to pass into the body's central conduit. This conduit is submerged in the water that half-fills the water bowl. The hose is not submerged, exits from the water bowl's top, and ends with a mouthpiece, from which the smoker inhales. The tobacco that is placed into the head is very moist (and often sweetened and flavoured): it does not burn in a self-sustaining manner. Thus, charcoal is placed atop the tobacco-filled head (often separated from the tobacco by perforated aluminium foil) (4, ~. When the head is loaded and the charcoal lit, a smoker inhales through the hose, creating a vacuum above the water, and drawing air through the body and over the tobacco and chazcoal. Having passed over the charcoal, the heated air, which now also contains charcoal combustion products, passes through the tobacco, and the mainstream smoke aerosol is produced (~. The smoke passes through the waterpipe body, bubbles through the water in the bowl, and is carried through the hose to the smoker (~. During a smoking session, smokers typically replenish and adjust the charcoal periodically. A pile of lit chazcoal may be kept in a neazby firebox for this purpose. As an alternative, smokers may opt for commercially available quick-lighting charcoal briquettes. There are regional and/or cultural differences in some waterpipe design features, such as head or water bowl size, number of mouthpieces, etc., but all 75A-10 waterpipes contain water through which smoke passes prior to reaching the smoker. Names for the waterpipe also differ, and include "narghile" in East Mediterranean countries including Turkey and Syria, "shisha" and "goza" in Egypt and some North African countries, and "hookah" in India (8). Waterpipes can be purchased from dedicated supply shops, including Internet vendors, which also sell charcoal, tobacco and accessories. Waterpipes are now being marketed as portable, with the introduction of accessories such as carrying cases with shoulder straps. Some accessories are sold with claims to reduce the harmfulness of the smoke, such as mouthpieces that contain activated charcoal or cotton, chemical additives for the water bowl, and plastic mesh fittings to create smaller bubbles. None of these accessories have been demonstrated to reduce smokers' exposure to toxins orrisk oftobacco-caused disease and death. Health effects Contrary to ancient lore and popular belief, the smoke that emerges from a waterpipe contains numerous toxicants known to cause lung cancer, heart disease, and other diseases (4). Waterpipe tobacco smoking delivers the addictive drug nicotine, and, as is the case with other tobacco products, more frequent use is associated with the smokers being more likely to report that they are addicted (9). A waterpipe smoking session may expose the smoker to more smoke over a longer period of time than occurs when smoking a cigarette. Cigarette smokers typically take 8-12, 40-75 ml puffs over about 5-7 minutes and inhale 0.5 to 0.61itres of smoke (10). In contrast, waterpipe smoking sessions typically last 20-80 minutes, during which the smoker may take 50-200 puffs which range from about 0.15 to 1 litre each (6). The waterpipe smoker may therefore inhale as much smoke during one session as a cigarette smoker would inhale consuming 100 or more cigarettes. While the water does absorb some of the nicotine, waterpipe smokers can be exposed to a sufficient dose of this drug to cause addiction (8, 11). Nicotine intake is an important regulator of tobacco intake in general, as evidenced by the fact that cigarette smokers tend to smoke until they get enough nicotine to satisfy their need and addiction, but not so much as to cause nausea (12,13). It is likely that the reduced concentration of nicotine in the waterpipe smoke may result in smokers inhaling higher amounts of smoke and thus exposing 75A-11 themselves to higher levels ofcancer-causing chemicals and hazardous gases such as carbon monoxide than if none of the nicotine was absorbed by the water; however, this issue needs further study (4, 14,1.x. This puts waterpipe smokers and second-hand smokers at risk for the same kinds of diseases as are caused by cigazette smoking, including cancer, heart disease, respiratory disease, and adverse effects during pregnancy (1~. Regional and global patterns of waterpipe smoking Waterpipe smoking is often social, and two or more people may share the same waterpipe (3, c~. In South-West Asia and North. Africa, it is not uncommon for children to smoke with their parents (1 ~. If used in a commercial establishment such as a cafe or restaurant, the waterpipe is ordered (often from a menu of flavours) and an employee prepares it from an in-house stock (8). Globally, the highest rates of smoking occur in the African Region (primarily North Africa), the Eastern Mediterranean Region and the South-East Asia Region (~. Since the 1990s waterpipe smoking appears to be spreading among new populations such as college students and young persons in the United States, Brazil and European countries. Waterpipe smoking appears to be stimulated by unfounded assumptions of relative safety compared to cigarettes, as well as the social nature of the activity (I8). Commercial marketing, often with implicit or explicit safety-related claims, may also be contributing to the spread of waterpipe smoking across the globe. Waterpipe smokers may use waterpipes exclusively; however, many smokers may also smoke cigarettes. In some countries in which cigazette smoking is concentrated among men, waterpipe smoking appears more evenly distributed between both sexes (8, 19). All these findings reinforce the need to conduct more research on waterpipes and the issues surrounding their use, and then to disseminate the information on the health risks to all countries. Science base and conclusions Waterpipe smoking has not been studied as intensively as has cigarette smoking; however, preliminary research on patterns of smoking, the chemistry of the smoke that is inhaled, and health effects supports the idea that waterpipe smoking is associated with many of the same risks as cigarette smoking, and may, in fact, involve some unique health risks. The science base supports the following conclusions: 75A-12 1. Using a waterpipe to smoke tobacco poses a serious potential health hazard to smokers and others exposed to the smoke emitted (9). 2. Using a waterpipe to smoke tobacco is not a safe alternative to cigazette smoking (4). 3. Atypical 1-hour long waterpipe smoking session involves inhaling 100- 200 times the volume of smoke inhaled with a single cigarette (~. 4. Even after it has been passed through water, the smoke produced by a waterpipe contains high levels of toxic compounds, including cazbon monoxide, heavy metals and cancer-causing chemicals (8, 14). 5. Commonly used heat sources that aze applied to burn the tobacco, such as wood cinders or charcoal, are likely to increase the health risks because when such fuels are combusted they produce their own toxicants, including high levels of carbon monoxide, metals and cancer-causing chemicals (7, IS). 6. Pregnant women and the fetus aze particulazly vulnerable when exposed either actively or involuntazily to the waterpipe smoke toxicants (1~. 7. Second-hand smoke from waterpipes is a mixture of tobacco smoke in addition to smoke from the fuel and therefore poses a serious risk for non- smokers (8). There is no proof that any device or accessory can make waterpipe smoking safer. 9. Sharing a waterpipe mouthpiece poses a serious risk of transmission of communicable diseases, including tuberculosis and hepatitis (4). 10. Waterpipe tobacco is often sweetened and flavoured, making it very appealing; the sweet smell and taste of the smoke may explain why some people, particularly young people who otherwise would not use tobacco, begin to use waterpipes (20). 75A-13 Research needs There is surprisingly little reseazch addressing tobacco smoking using a waterpipe, especially given that there are many millions of current waterpipe smokers and that waterpipe use is spreading across the globe. A more thorough understanding of waterpipe smoking, risks, and health effects requires worldwide efforts to study: 1. Types and patterns of smoking across regions and cultures. 2. National and global trends in waterpipe smoking. 3. How the chemical and physical properties of the smoke depend on the waterpipe set-up and smoking conditions (geometry of waterpipe, amount/type of coal and tobacco used, puffmg behaviour, etc.). 4. Methods for evaluating toxicant yield, smoker exposure, and resultant absorption. 5. Patterns of smoking by individuals and how different smoking patterns relate to the smokers' intake of smoke toxicants, including nicotine, cazcinogens, cazbon monoxide, and other disease-causing compounds. 6. Relationships among yield, exposure, and absorption biomazkers. 7. Pharmacology and toxicology of smoke as assessed in laboratory tests using biological assays and in actual use by people. 8. Epidemiology of waterpipe-associated disease risk, including addiction and transmission ofnon-tobacco, communicable diseases. 9. The influence of cultural and social practices on initiation and maintenance. 10. The relationship between waterpipe smoking and other forms of tobacco, including substitution and multiple product smoking. 11. The relationship between waterpipe smoking and the use of other drugs, including marijuana. 12. Development of prevention and cessation strategies. 75A-14 Suggested actions for regulators (consistent with the definition of "tobacco product" under the WHO Framework Convention on Tobacco Control)t The WHO's Study Group on Tobacco Product Regulation (TobReg) urges consideration of the following public health initiatives to reduce waterpipe smoking and associated disease. 1. Waterpipes and waterpipe tobacco should be subjected to the same regulation as cigazettes and other tobacco products. 2. Waterpipes and waterpipe tobacco should include strong health warnings. 3. Claims of harm reduction and safety should be prohibited. 4. Misleading labelling, such as "contains 0 mg tar", which may imply safety should be prohibited. 5. Waterpipes should be included in comprehensive tobacco control efforts, including prevention strategies and cessation interventions. 6. Waterpipes should be prohibited in public places consistent with bans on cigarette and other forms of tobacco smoking. 7. Education of health professionals, regulators and the public at lazge is urgently needed about the risks of waterpipe smoking, including high potential levels of second-hand exposure among children, pregnant women, and others. 8. The TobReg recommends that a full document be produced in the WHO Technical Report. Series to evaluate thoroughly the health effects of waterpipes and to develop recommendations. ' Article l.f states that "tobacco products" mean products entirely or partly made of the leaf tobacco as raw materials which are manufactured to be used for smoking, sucking, chewing and snuffmg. - _~ a7~~-~~7---- _ References 1. Chattopadhyay A. Emperor Akbaz as a healer and his eminent physicians. Bulletin of the Indian Institute of the History of Medicine, 2000, 30:151- 158. 2. Ibid., p. 154. 3. Maziak W, Eissenberg T, Wazd KD. Waterpipe use and dependence: implications for intervention development. Pharmacology, Biochemistry, and Behavior, 2005, 80:173-179. 4. Knishkowy B, Amitai Y. Water-pipe (nazghile) smoking: an emerging health risk behavior. Pediatrics, 2005, 116(1):e113-e119. 5. Shihadeh A, Antonius C, Azaz S. A portable, low-resistance puff topography instrument for pulsating, high flow smoking devices. Behavior Research Methods, Instruments, & Computers, 2005, 37(1):186-191. 6. Shihadeh A et al. Towards a topographical model of nazghile water-pipe cafe smoking: a pilot study in a high socioeconomic status neighborhood of Beirut, Lebanon. Biochemistry, Pharmacology, and Behavior, 2004, 79(1):75-82. 7. Shihadeh A. Investigation of mainstream smoke aerosol of the azgileh water pipe. Food and Chemical Toxicology, 2003, 41:143-152. 8. Maziak W et al. Tobacco smoking using a waterpipe: a re-emerging strain in a global epidemic. Tobacco Control, 2004,13:327-333. 9. Maziak W, Ward KD, Eissenberg T. Factors related to frequency of nazghile (waterpipe) use: the first insights on tobacco dependence in nazghile users. Drug and Alcohol Dependence, 2004, 76:101-106. 10. Djordjevic MV, Stellman SD, Zang E. Doses of nicotine and lung cazcinogens delivered to cigazette smokers. Journal of the National Cancer Institute, 2000, 92(2):106-111. 11. Shafagoj YA, Mohammed FI, Hadidi KA. Hubble-bubble (water pipe) smoking: levels of nicotine and cotinine in plasma, saliva and urine. International Journal of Clinical Pharmacology and Therapeutics, 2002, 40(6):249-255. 12. National Cancer Institute. Risks associated with smoking cigarettes with low machine-measured yields of tar and nicotine. Smoking and Tobacco Control Monograph No. 13. Bethesda, MD, United States Department of Health and Human Services, Public Health Service, National Institutes of Health, National Cancer Institute, 2001. 13. Royal College of Physicians of London. Nicotine addiction in Britain: a report of the Tobacco Advisory Group of the Royal College of Physicians. London, Royal College of Physicians of London, 2000. 14. Sajid KM, Akhter M, Malik GQ. Cazbon monoxide fractions in cigazette and hookah (bubble bubble) smoke. Journal of the Pakistan Medical Association, 1993, 43(9):179-182. 15. Shihadeh A, Saleh R. Polycyclic azomatic hydrocazbons, carbon monoxide, "tar", and nicotine in the mainstream smoke aerosol of the nazghile water pipe. Food and Chemical Toxicology, 2005, 43(5):655- 661. 16. Nuwayhid IA et al. Narghile (bubble-bubble) smoking, low birth weight, and other pregnancy outcomes. American Journal ofEpidemiology,1998, 148: 375-383. 17. Kandela P. Nargile smoking keeps Arabs in wonderland. Lancet, 2000, 356:1175. 18. Shafagoj YA, Mohammed FI. Levels of maximum end-expiratory cazbon monoxide and certain cazdiovasculaz pazameters following bubble-bubble smoking. Saudi Medical Journal, 2002, 23:953-958. 19. Tamim H et al. Tobacco use by university students, Lebanon, 2001. Addiction, 2003, 98:933-939. 20. Rastam S et al. Estimating the beginning of the waterpipe epidemic in Syria. BMC PublicHealth, 2004, 4:32. 9 75A-17 Annex Members of the WHO Study Group on Tobacco Product Regulation Erik Dybing, MD, PhD, Chair of the WHO Study Group on Tobacco Product Regulation, Director, Division of Environmental Medicine, Norwegian Institute of Public Health (NIPH), Oslo, Norway David L. Ashley, PhD, Chief, Emergency Response and Air Toxicants Branch, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA David Burns, MD, Professor of Family and Preventive Medicine, University of California, San Diego, School of Medicine, California, USA Mirjana Djordjevic, PhD, Program Director, National Cancer Institute, Division of Cancer Control and Population Sciences, Tobacco Control Research Branch, Bethesda, Maryland, USA Nigel Gray, MBBS, Scientist, International Agency for Research on Cancer, Lyon, France S. Katherine Hammond, PhD, Professor of Environmental Health Sciences, University of California, Berkeley, School of Public Health, Berkeley, California, USA Jack Henningfield, PhD, Vice President, Research and Health Policy, Pinney Associates, Bethesda, Maryland, USA Martin Jarvis, DSc, Principal Scientist, Cancer Research UK, Health Behaviour Unit, Royal Free and University College London Medical School, London, United Kingdom K. Srinath Reddy, MD, DM, Professor of Cardiology, All Institute of Medical Sciences, Delhi, India Charming Robertson, PhD, Senior Associate Dean for Faculty and Academic Affairs, School of Engineering, Stanford University, California, USA Ghazi Zaatari, MD, Professor and Chairman, Department of Pathology and Laboratory Medicine, American University of Beirut, Beirut, Lebanon io 7rJ~-- _ WHO secretariat Vera da Costa a Silva, MD, PhD, MBA, Director, WHO Tobacco Free Initiative Douglas William Bettcher, MD, PhD, MPH, Coordinator, WHO Framework Convention on Tobacco Control Team, WHO Tobacco Free Initiative Gemma Vestal, JD, MPH, MBA, RIV, Legal Officer/Scientist, WHO Tobacco Free Initiative tt HOOKAH PARLOR SURVEY RESULTS OF SURROUNDING nRAN(TF C'nUNTRY CITIES City Classified as Zones Action Required Permitted Anaheim Bars/nightclubs Commercial Meet business license operating standards and parking 17spaces/1000 Buena Park Currently no smoking lounges located in city, researching ordinance Burbank Retail/restaurant Commercial Allowed in any commercial zone as long as it meets requirements of AB13 and parking requirement. In restaurant settings location of _ smoking area regulated. Costa Mesa Assembly use Commercial Meet parking requirements Fullerton Commercial CUP Garden Grove Smoking lounges Commercial (C- _ CUP 2 & C-3) Huntington Retail/restaurant Commercial Meet parking requirement Beach _ Irvine Retail/restaurant Commercial Not prohibited "yet" Example: Allowed on ~ outdoor patio in conjunction with restaurant use. La Habra Commercial CUP Long Beach Retail -tobacco sales _ Commercial No smoking allowed indoors Oran e Not permitted use Pasadena Significant tobacco General CUP required, must be retailer (20% or more Commercial, 3 000 feet from sensitive of display area devoted General land uses (day care, to sale or exchange of Industrial library, game arcade), not tobacco products or permitted in conjunction paraphernalia) with alcohol service San Die o Smoking lounge Commercial CUP required Westminster Currently do not have any lounges, ect. Code does not address, don't believe it would be a permitted use, haven't had any inquires ZOA 07-6 EXHIBIT 2 75A-20 l~'t ~i ~' 1*RDRP rne.oco-d Dlsw~ \ I IZI>IZI' I'ubliratiun ~'~~~~++~ \rurl~ I~~~~rml - ~i~lumc ~. ~umhrr ~\u~ua 2O0~ Hooked on Hookah? What You Obn't KMow Can 1 11 You by Kamlesh Asotra, Ph.D. "Harmful hookahs lure a young crowd "-announces the headline of a recent Contra Costa Times article. According to the article, public health professionals in California are very concerned about hookah smoking among our youth.' Researchers across the globe have echoed similar concerns.Z•' A growing number of college students and others in the United States who have tried or now regularly participate in hookah smoking claim that they do not smoke cigarettes or use tobacco. Most of these individuals believe that hookah smoke is neither addictive nor as harmful as cigarette or cigar smoke.' This sense of false security may be perpetuated by the myth that the hookah smoke, after bubbling through water becomes devoid of the harmful elements that are present in cigarette smoke. Among more than 1 billion smokers worldwide, 100 million people in Africa, Asia, and the Middle East use water pipe or hookah to smoke tobacco. Water pipe is var- iously known in different regions as hookah (Indian sub- continent and Africa), shisha, borry, goza (Egypt, Saudi Arabia), narghile, arghile (Jordan, Lebanon, Syria, and Israel), shui yan dai (China), or bubble-bubble. It's believed to have originated in India in the 16th century and found its way to Persia (Iran), Turkey, and the Eastern Mediterraneans In the last 25 years, hookah smoking has become increasingly popular in Arab societies, Europe, and the United States due mainly to the cultural and social practices of new immigrants from countries where hookah smoking is an accepted tradition. Recently, hookah bars have mushroomed across California and in several other states with sizable Arab-American popula- tions. More than 300 hookah bars are operating in the United States, with at least 50 in California. Many are located near colleges, universities, and shopping malls and are frequented by college students and locals. The bars offer an "exotic ambience" where customers can smoke a variety of fruit flavors and aromas in smoking sessions that last 45 to 60 minutes, for the cost of about $15.^ Is hookah smoke really so innocuous? This article describes hookah smoke chemistry and highlights facts related to hookah smoking and diseases that deserve attention and further scientific research. Hookah tobacco combustion-"cool" burning Hookah or water pipe is made of a clay bowl, body, water reservoir, and a stem or hose for inhalation of tobacco smoke. Hookah tobacco--inu'essel or maassel (assal means EXHIBIT B 75A-21 TABLE A Chemicals found in hookah smoke versus cigarette smoke Adapted from Shihadeh and Saleh" Chamieal Yield from ; Yield from 1 gm hookah cigarette smoke, tobacco 1 gm tobacco Multiple of average cigarette smoke value Combustion chemistries involved in the produc- . tion of mainstream cigarette smoke and main- stream hookah smoke differ due to widely differ- old bustion. These include carbon monoxide (CO), d metals like arsenic, nickel, cobalt, chromium, d Lebanon." Shihadeh and Saleh carried out strin- d of hookah smoke. They found that hookah smoke ent combustion temperatures and the dry or humid characteristics of tobacco. In both cases, plant-derived organic matter undergoes pyrolysis or volatilization, producing addictive nicotine as well as a number of the same toxicants from com- "tar," and myriad carcinogenic polycyclic aromat- ic hydrocarbons (PAH). Also, hookah smoke con- twins significantly higher quantities of toxic heavy lead,'° and cadmium12, as compared with cigarette smoke." These facts about hookah smoke are a d "screarniiig warning" that hookah srrioking is harmful. In a carefully designed recent study, researchers Shihadeh and Saleh used a smoking machine that d replicated the puffmg mechanics derived from precise measurements of 52 hookah smokers in gently controlled quantitative chemical analyses produced nearly two orders of magnitude greater amount of "tar" from a single smoking session than that produced from a single cigarette. Simply put, hookah smoke produces nearly 100 times more "tai" than cigarette smoke, for each gram of the respective tobaccos. Table A shows that hookah smoke contains several-fold greater quantities of harmful chemicals thus far studied than found in cigarette smoke. In light of these recent chemical data on selected con- stituents of hookah smoke as compared with those of mainstream cigarette smoke, hookah smoke of various fruity flavors, tastes, and aromas may be even more harmful than disease-causing cigarette tobacco smoke. _.__ t --__ _. -- - i i "Tar," mg 802 ~ Range:l-27 ' 100-f Average:11.2 + F Nicotine, mg 2.9fi j Range: 0.1-2 4-fol i - Average: 0.77 ~ Carbon monoxide ~ _ 143 - •- ~ Range: 1-22 ~ -- 11-fol CO,mg ' Average: 12.6 PAH C - __-__ Phenanthrene, Ng ! 0.748 ! 0.2-0.4 2.5-fol (co-carcinogen) lI Fluranthracene, pg 0.221 3 ~ 0.009-0.099 4-fol (co-carcinogen) Chrysene, Ng 0.112 ~ 0.004-0.041 5-fol (tumor initiator) -) 1_ I honey in Arabic~is a moist, paste-like mixture of about 30% crude, cut tobacco, fermented with approximately 70% honey, molasses, and pulp of different fruits to cre- ate the fruity flavor and aroma of the smoke when sub- jected to slow combustion with burning charcoal. The combustion processes that produce cigarette smoke and hookah smoke are very different. Mainstream cigarette smoke is produced at 900°C. Hookah smoke is produced at nearly half that temperature at 450°C. Hookah smoke bubbles through water at the base reservoir. During a smoking session, more glowing charcoal is added to the partially consumed hookah tobacco once the original charcoal in the bowl is used up. As the hookah smoking session progresses, the reservoir water becomes increas- ingly brown in color on account of "tar," dissolved chem- icals, and other particulates in the hookah tobacco aerosol. The chemical waste-laden water is discarded and the hookah reservoir is then replenished with fresh water for the next smoking session. ~~~hai is in hookah smokc° During the last 40 years of research, nearly 4,800 chemi- cal compounds have been identified in cigarette smoke, including 69 carcinogens.b )n contrast, only five studies have been published in English on the chemical comp- osition of hookah smoke, and those focused on only a rel- atively small number of chemical compounds.'" ~~~ho says hookah smoking; isn't addictivc° Hookah smoking is an efficient nicotine delivery system. After a 45-minute hookah smoking session, the concen- trations of nicotine and its longer-lived metabolic prod- uct, cotinine, become significantly elevated in saliva, plasma, and urine.'° Comparison of urinary levels of coti- nine between hookah smokers and cigarette smokers sug- gests that in a single hookah smoking session using 20 grams of hookah tobacco, the hookah smoker is exposed to several-fold greater quantities of the addictive stimu- lant nicotine for up to 45 to 60 minutes. That is equivalent to chain-smoking 15 cigarettes.15 A cross sectional study on hookah smokers from 112 restaurants and cafes in Aleppo, Syria, reported that 96% of weekly hookah smokers and 50% of daily hookah smokers did not smoke 75A-22 cigarettes.z This survey found that 91% of weekly hookah smokers and 51 % of daily hookah smokers did not have the will to quit, which highlights the addictive nature of hookah smokingZ among myriad factors.16 ('arhon monoxide in hookah smoke: Effects on tun<~s. heart. ;end hrain Hookah smokers are exposed to three-fold greater amounts of CO-an odorless gas-than are cigarette smokers. Based on their chemical analysis, Shihadeh and Saleh" provide strong evidence that the CO-to-nicotine ratio in hookah smoke is 50:1, and that for cigarette smoke is 16:1. One of the reasons for the greater CO con- centrations in Hookah smoke is the charcoal that is added to enhance the burning of the moist tobacco concoction. Hemoglobin, the iron-containing protein in blood that transports oxygen from lungs to all parts of the body in vertebrates, has extremely high affmity for CO, and forms carboxyhemoglobin (COHb), which can no longer serve as either the oxygen acceptor or as the oxygen carrier. Hookah smokers have significantly higher levels of COHb in their blood than heavy cigarette smokers who smoke 15 to 40 cigarettes." Because the duration of a single puff of hookah smoke is double that of a cigarette, and the suction pressure for inhalation of hookah smoke is four times that fora ciga- rette, the hookah smoke reaches deeper into lung tissue.18 Consequently, hookah smoking may cause greater venti- latory incapacitation, especially in older individuals, than cigarette smoking causes.19 Since smoking rates among 18- to 24-year-olds are the highest of any age group in CaliforniaZ°, the recent trend of hookah smoking among youth, unless checked, may exacerbate the future inci- dence of chronic obstructive pulmonary disease. Blood pressure (systolic, diastolic, and mean), expired CO, and heart rate all increase upon hookah smoking.21 Heart and brain have extremely critical requirements for a minimal threshold of oxygen. Episodes of sudden and short periods of oxygen deprivation can result in heart attack or brain stroke.22 Chronic exposure to nicotine also has a direct effect on the heart, causing atrial flutter.23 This exposure leaves hookah smokers vulnerable to this debil- itating condition. How hookah smoke may affect fertility, virility anal babies It is becoming increasingly clear that, like tobacco smok- ing, mainstream hookah smoke and second-hand hookah smoke cause deleterious effects on reproductive systems in men and women and produce genotoxic24, mutagenic, and teratogenic25 effects on babies of smoking parents. These effects include infertility in females and sterility of males, and low birth weight z6, z' and birth defects in babies born to smoking mothers.28, z9 A recent study of 100 Egyptian infertile women determined that the couples' infertility was due to sterility of husbands who were hookah smokers.30 High concentration of CO is a major component of sec- ond-hand smoke from hookah. The contribution from burning charcoal in hookah may also have significant and deleterious effects on young babies that may be exposed to mild CO lev- els. Even at very low levels, such as 25 to 50 parts per million parts of air, CO can produce permanent damage to the inner ear in young babies and irreversible loss of hearing."-" TRI)RP research on hookah smoking TRDRP is at the forefront of recognizing and supporting inno- vative and novel ideas in a proactive manner. Keeping with its mandate, TRDRP funds innovative and high-quality biomed- ical, policy, and prevention research in California. This research aims to mitigate the suffering and economic burden due to myriad diseases caused by tobacco products. This year, as over the past 15 years, TRDRP has once again distinguished itself among all federal and public fund- ing agencies in leading the charge against tobacco by award- ing the first ever research grant on hookah smoke. TRDRP has made athree-year new investigator grant award to Nada Kassem, Dr.P.H., M.S., R.N., C.H.E.S., to study "Water Pipe Use, ETS Exposure and Home Policies among Arab Americans." Dr. Kassem is currently a faculty research investigator at the Center for Behavioral Epidemiology and Community Health, Graduate School of Public Health, San Diego State University. This is the first tobacco-related research grant award to Dr. Kassem. TRDRP invites research grant applications from California scientists on all aspects of hookah smoke for various funding mechanisms. Dedicated to the fond memory of Sureruler S. Katoch, B.Sc., M.Sc., M.Phil., Ph.D. - a dear friend and scientific collaborator -who dedicated his life to mitigating cardiovascular disease, and sod - denlydied on May 14, 2005 due to a massive heart attack. Dr. Katoch was Professor and Chairman, Department of Bio-Sciences, Himachal Pradesh University, Shimla, India. Surender will be sorely missed by family members and numerous friends all over the world. 3 Author's contact information: Kamlesh Asotra, Ph.D. Tobacco-Related Disease Research Program University of California O•(ju:e of the Prersident 3001akeside Driue, 6th Floor Oakland CA 946/2 (SIO) 287-3366 kcvr~leshasotrzi(, u co p. ed u www.trdrp.org 75A-23 References: !. Spear, P. (2005). Harmful hookahs lure a young crowd Contra Costa Times, July !3, 2005. wwwcontracostatimes.com/ccdmes/emaiUnew/ 12l10730.htm. 2. Mazial~ W., Want, K.D., and Eisenberg, T. (2004). Factors related to frequency of narghile (waterpipe) use: the fast insighu on tobacco dependence in narghile users. Drug and Alcohol Dependence, 76: /01-106. 3. Knishkowy, B. and Amitai, Y. (2005). Water pipe (Narghi(e) smoking: An emerging health risk behavior. Pediatrics, 116(I):e113-e119. 4. Hillery, L. (2005). Up in smoke. Arizona Daily Wildcat. February 22, 2005. http:/hviilcat.arizona.edu/papers/98/!03/04_l.html. 5. The Origin ofHaokah. wwwbbc.co.uk/dna/h2g2/A987825, accessed on July 12, 1005. 6. Hoffmann, D., Hoffman, L, and El-Bayoumy, K. (2001). The less harmful cigarette: A controversial issue. A Tribute to Ernst L. {i~ynder. Chemical Research in Toxicology, 14:767-790. 7. Rakower, J. and Fatal, B. (1961). Study of narghile smoking in relation to cancer of the lung. British Journal ojCancer, 16(!):1-6. 8. Hoffman, D., Rathkamp, G, and Wynder, E. (1963). Comparisan of the yields ojseveral selected components in the smoke from different tobacco products. Journal of the National Cancer Insthute, 31(3):627-635. 9. Sajid, K.M., Akhter, M, and Malik, G.Q. (1993). Carbon monoxide fractions in cigarette and hookah (hobble bubble) smoke. Journal of Pakistan Medical Association, 43(9): /79-182. 10. Shihadeh, A. (2003). Investigation ojmainstream smoke aerosol of the argileh water pipe. Food & Chemical Toxicology, 41:143-152. 1 /. Shahadeh, A. and Saleh, R. (1005). Pdycyclic aromatic hydrocarbons, carbon monoxide, "tar'; and nicotine in the mainstream smoke aerasol of the narghile water pipe. Food & Chemical Toxicology, 43:655-661. /2. Sukumar, A. and Subramanian, R (1992). Elements in hair and nails of residents from a village adjacent to New Delhi. /rfluence of place of occupation and smoking habits. Biol. Trace Ele. Res., 34:99-105. 13. Hoffman, D. and Hoffman, 1. Letters to the Editor, Tobacco Smoke Components. Beitrage zur Tabakforschung /nternational, 18:49-51; cited in Jenkins R., Guerin M., and Tomkins, B. (2000). The Chemistry of Environmental Tobacco Smoke. Lewis Publishers, Boca Raton, FL. /4. Safajog, Y.A., Mohammed, F.L, and Haididi, K.A. (1002). Hubble-bubble (water pipe) smola'ng.• levels of nicotine and cotinine in plasma, saliva and urine. /nt. J. Clin Pharmacol. 7her., 40:249-155. /5. Macaron, C., Macaron, Z, Maalouf, M.T., Macaron, N., and Moore, A. (1997). Urinary cotinine in narguila or chichi tobacco smokers. J Med. Liban., 45(10):19-10. !6. Maziak, W., Eisenberg, T., and Waal, K.D. (2005). Patterns ojwaterpipe use and dependence: implications for intervention development. Pharmacology, Biochemistry & Behavior, 80:173-179. !7. Zaharan, FZahran F, YousejA.A., and Baig M.H. (1981). A study of car- boxyhaemoglolx'n levels of cigarette and sheesha smokers in SaudiArabia. Am. J Public Healt, 72(7):722-724. l8. Salem, E.S. and Sami, A.S. (1974). Studies on pulmonary manfestationr ofgoza smokers. Chest. 65:599. 19. A/-Fayez S.F., Salleh M, Ardawi M, and Zahran F.M. (1988). Effects of sheesha and cigarene smoking on pulmonary function of Saudi males and females. Trop. Geogr. Med, 40(2):115-123. 10 California Department ofHealth Services. (2003). Smola'ngprevalence among 18-14 year olds. Tobacco Control Section Fact Sheet. www.dhs.ca.gov/tobacco/documents/18-24 YearOldspdj 21. Safajog, Y.A. and Mohammec! F.I. (1001). Levels of maximum end~xpi- ratory carbon monoxide and certain cardiovascular parameters following Nubble-bubble smoking. Saudi Med J., 23:953-958. 12. Asotra, K (2004). Tobacco-caused cerebrovascular disease: Urgent need for increased research funding. Burning Issues, 7(!):8-9, 13-I5. 23. Miyauchi, M, Qu, Z, Miyauchi, Y., Zhou, S-M., Pak, H., Mandel, W.J., Fishbein, M.C., Chen, P-S., and Karagueuzian, H.S. (1005). Chronic nico- tine in hearts with healed ventricular myocarclial infarction promotes atri- a(flutter that resembles typical human atrial flares. Am. J. Physiol. Heart Circ. Physiol.. 188.• H2878-H2886. 14. Yadav, J.S. oral Thakur, S (1000). Genetic risk assessment in hookah smokers. Cytobias., 101: /01-1/3. 25. Johnston, C (1981). Cigarette smoking and the outcome of human preg- nancies: Astatus report on the consequences. Clinical Toxicology, 18(2):189-209. 26. Nuwayhid, /.A., Yamount, B., Azar, G., and Kambrts, M.A.K. (1998). Narghile (Nubble-bubble) smoking, low birth weight, and other pregnancy outcomes. Am. J. Epudemiol., 148:375-383. 17. Misra, D.P., Atone, N., and Lynch, C.D. (1005). Maternal smoking and birds weight. Interaction with parity and mother's own in utero exposure to smoking. Epidemiology, /6(3)188-293. 28. Lammer, EJ., Shaw, G.M., lovannisci, D, and Finell, R.H. (2004). Maternal smoking during pregnancy, genetic variation of acetyl-N-trans- jerase (NAT) 1 and 2, and risk of orofacia! clefts. Epidemiology, 15:150-156 29. Lammer, EJ., Shaw, G.M., /ovannisci, D, and Finell, R.H. (2005). Maternal smoking during pregnancy, genetic variation ojglutathione-S- transjerase, and risk jor orfacral clefts. Epidemiology, 16(5) - in press. 30. /nhorn, M.C. and Buss, K.A. (1994). Ethnography, epidemiology and infertility in Egypt. Soc. Sci. Med., 39:671-686. 31. Stockard-Sullivan, J.E., Korsak, RA., Webber, D.S., and Edmond, J. (2003). Mild carbon monoxide exposure and auditory junction in the developing rat. J. Neurosci. Res., 74:644-654. 32. Webber, D.S, Korsal~ R.A., Sininger, L.K., Sampogrra, S.L., and Edmond J. (2003). Mild carbon monoxide exposure impairs the developing audit- ory system of the rat J. Neurosci. Res., 74:655-665. 33. Lopez, L, Acura, D., Webber, D.S., Korsalt R.A., and Edmonr~ J. (1003). Mild carbon monoxide exposure diminishes selectively the intergrity of choclea of the developing rat. J. Neurosci. Res., 74:666675. 34. Webber, D.S., Lopez, L, Korsak, RA., Hirota, S, Acura, D., and Edmond, J. (2005). Limiting iron availability confers neuroprotection from chronic mild carbon monoxide exposure in the developing auditory system ojthe rat. J. Neuroses. Res., 80(5):620-633. 35. Rao, D. B. and Fechter, L.D. (2000). Increased noire severity lrmiu poten- tlation ofnoise induced hearing lass by carbon monoxide. Hearing Research, 150.•205-214. 4 75A-24 CAP This material made possible by funds from the California Department of Health Services under contract # OS-45720. nn.,«r, zoa Deadly Victoria blaze caused by hookah pipe: fire chief Deadly Victoria blaze caused pipe: fire chief Last Updated: Wednesday, August 22, 2007 ~ 5:50 PM ET CBC News Page 1 of 2 by hookah A hookah pipe caused a fire that claimed the lives of two young women in Victoria in the early morning of Aug. 6, Victoria's fire chief says. Fire Chief Doug Angrove said an investigation has concluded the group of university students had been smoking tobacco from the water pipe on the evening of Aug. 5. Some time after midnight, the hookah pipe tipped over and a smouldering charcoal ember fell onto a couch, Angrove said. That led to a fire so intense that it peeled aluminum siding off the duplex. Chelsea Elizabeth Robinson, 22, and Brenna Jacklyn Innes, 21, died from smoke inhalation when the two-story duplex caught fire while they were sleeping. Angrove said smoking tobacco from a hookah pipe has become a popular pastime among young urbanites. "This is the first fire I am aware of as a result of these pipes," said Angrove. "It is something we haven't come across before and this was a terrible way to learn more about them." Angrove said he's concerned the unstable design of many hookah pipes could lead to other fires. Upon further investigation into the unstable design of the pipe, the slow- and long-burning characteristics of the charcoal and the growing popularity, we are extremely concerned about the fire potential here." Although there was a smoke alarm in the duplex, it appears it was not working at the time of the fire, said Angrove. The fire broke out in the duplex in the 800 block of Villance Street in the northwest of the city at about 4:30 a.m. PT Aug. 6. By the time fire crews arrived, half of the duplex was engulfed in flames. The two women who died, students from the University of Victoria, were visiting other university students at the duplex. One was found on the ground floor, the other in an upstairs bathroom. Three young men escaped by jumping out of windows. Two others were badly burned. EXHIBIT C http://www.cbc.ca/Canada/briths-columbia/sto~~11.~~1 /bc-hookahfire.html 1 /28/2008 Deadly Victoria blaze caused by hookah pipe: fire chief Page 2 of 2 Victoria's fire chief says smoking a hookah pipe has become popular among young urbanites. http://www.cbc.ca/Canada/briths-columbia/stora{0~(~ /bc-hookahfire.html 1 /28/2008 bk:1 /29/08 ORDINANCE NO. NS-XXX AN ORDINANCE OF THE CITY COUNCIL OF THE CITY OF SANTA ANA ADDING ARTICLE XIV TO CHAPTER 18, AND ADDING SECTION 41-73.5 AND AMENDING SECTION 41-144 OF THE SANTA ANA MUNICIPAL CODE TO PROHIBIT THE ESTABLISHMENT AND OPERATION OF HOOKAH PARLORS THE CITY COUNCIL OF THE CITY OF SANTA ANA DOES ORDAIN AS FOLLOWS: Section 1. The City Council of Santa Ana hereby finds, determines and declares as follows: A. Provisions of the General Plan of the City and Chapter 41 of the Santa Ana Municipal Code do not specifically identify hookah parlors as a land use or designate zoning districts throughout the City where hookah parlors may be permitted. B. For this reason, on February 21, 2006, at a regularly scheduled public meeting the City Council adopted Ordinance No. NS-2707, which established a moratorium on the construction or establishment of a hookah parlor (hereafter "the moratorium ordinance"). On April 3, 2006, following a noticed public hearing, the City Council adopted Ordinance No. NS-2709, which extended this moratorium 10 months and 15 days, and on February 5, 2007, following a noticed public hearing, the City Council adopted Ordinance No. NS-2709, which extended this moratorium one year. C. It has come to the City Council's attention that within the last two plus years at least two individuals have made efforts in an attempt to illegally establish a hookah parlor in Santa Ana. D. Hookah parlors have been shown to create the following deleterious effects on the public health, safety and general welfare: 1. In other cities, the operation of hookah parlors have led to complaints of loud music, drinking in public and large crowds milling outside of the site. 2. The Orange County Register reports (November 10, 2005) that in two and one-half (2'/2) years the Anaheim Police Department has responded to 413 incidents tied to hookah Ordinance No. NS-XXX 7 5A-2 8 Page 1 of _ parlors. The Anaheim Police Department reported to its City Council that this number does not include an additional 86 police calls on hookah parlors that were made without a request to a Police response (for a total of 499 police calls on hookah parlors over 2 1/2 years). 3. This same Police Department Report and news article further states that illegal weapons and underage drinking were found by an Anaheim Police Department vice operation directed at hookah parlors. 4. This Police Department Report and news article further stated that some hookah parlors in Anaheim had been the target of fire bombs and arson. 5. While there is a widespread belief that smoking from a hookah pipe is safer than other types of tobacco smoking, the World Health Organization ("V1/HO") reported in 2005 that "waterpipe smokers and second-hand smokers [are] at risk for the same kinds of diseases as are caused by cigarette smoking, including cancer, heart disease, respiratory disease, and adverse effects during pregnancy." 6. The WHO investigatory panel also found that a "typical 1- hour long waterpipe smoking session involves inhaling 100- 200 times the volume of smoke inhaled with a single cigarette," and that the smoke, even after passing through water, "contains high levels of toxic compounds, including high levels of carbon monoxide, metals and cancer-causing chemicals." 7. The WHO investigatory panel also found that sharing a hookah's mouthpiece poses a serious risk of transmission of communicable diseases. 8. The WHO investigatory panel found that the common practice of sweetening and flavoring hookah tobacco, giving it a sweet taste and smell, may account for the increase of its use among young people who otherwise avoid smoking. 9. The smoking of tobacco in a hookah "is frightening because it is a gateway toward a lifetime use of tobacco, including cigarettes," according to Dr. Christopher Loffredo, Ph.D., Director of the Cancer Genetics and Epidemiology program at Georgetown University Medical Center, who has studied hookah smoking since 1997. Dr. Loffredo further reports Ordinance No. NS-XXX Page 2 of 4 75A-29 that: "People think the water absorbs the toxins, and that is true to some extent if the toxins are water soluble, but tar isn't, and tar contains the carcinogens. We believe that, compared to the typical cigarette smoker, waterpipe smokers are exposed to larger total amounts of nicotine, carbon monoxide and certain other toxins. And because the tobacco is burning at a lower temperature, it is more tolerable to inhale deeply, and in fact you need more force to pull air through the high resistance of the water pathway. That means the tobacco smoke can be penetrating deeper in a person's respiratory tract than cigarette smoke does. The damage could be even worse than seen in cigarette smokers, but we haven't done studies long enough to quantify the true cancer risk." 10. According to Dr. Loffredo, another concern is that hookah use may represent a loophole around city and state laws banning smoking in public places. 11. While California Labor Code section 6404.5 generally bans indoor smoking at restaurants and bars, it exempts smoking inside retail or wholesale tobacco shops and private smokers' lounges. Many hookah bar owners claim they are tobacco retailers and state law does not clearly repudiate this claim. This allows tobacco smoking inside establishments where people work, eat and drink. Hookah smoking is not a safe alternative to smoking tobacco. Smoking hookah pipes has been reported to cause oral, esophageal and lung cancer, as well as heart disease, chronic bronchitis and of course, nicotine addiction. 12. According to a report authored by Dr. Kamlesh Asotra, Ph.D., for the University of California Tobacco Related Disease Program, hookah parlors create unique problems of second hand smoke, due to the increased presence of carbon monoxide (CO), which is present both in the tobacco smoke and the burning of charcoal indoors to ignite the tobacco. Dr. Asotra reports that "It is becoming increasingly clear that, like tobacco smoking, mainstream hookah smoke and second-hand hookah smoke cause deleterious effects on reproductive systems in men and women and produce genotoxic, mutagenic, and teratogenic effects on babies of smoking parents." Many commercial tenant spaces in Santa Ana share a ventilation system with other spaces within the same building, thus allowing second hand smoke from hookahs to propagate throughout an entire building. Ordinance No. NS-XXX 7 5A-3 0 Page 3 of _ 13. The California Legislature approved a bill this year, AB 1467, which would have expressly banned hookah parlors throughout California. This bill, which would have additionally banned cigar lounges, and smoking in hotel lobbies and meeting rooms, was vetoed by the Governor on October 14, 2007. E. If hookah parlors are permitted in the City, they will pose a serious threat to the public health, safety and general welfare for the following reasons: 1. Hookah parlors established in other cities have been associated with increases in noise, loitering, public drinking, possession of illegal weapons, underage drinking, and arson. 2. Hookah parlors could exacerbate the inherently dangerous behavior of tobacco use around non-tobacco users; diminish the protection of children from exposure to smoking and tobacco while they increase the potential for minors to associate smoking and tobacco with a healthy lifestyle; and weaken the protection of the public from smoking and tobacco-related pollution. Hookah parlors would additionally create unique problems of second hand smoke, because of the hot charcoal coals used to enhance the burning tobacco. 3. Hookah parlors if allowed in the City would have adverse secondary effects on surrounding properties, including but not limited to lowering property values and introducing incompatible land uses to existing neighborhoods. F. In response to the threat of unregulated hookah parlors several cities, including but not limited to the Cities of Anaheim, Garden Grove, and Dublin California, have adopted moratoriums or development restrictions. Other cities, such as New York and Calgary, Alberta, and the State of Washington, have simply banned them. Other countries, including the United Kingdom, France, Germany and Turkey, have banned hookah parlors. G. The Request for Council Action for this ordinance dated February 4, 2008 and duly signed by the City Manager shall, by this reference, be incorporated herein, and together with this ordinance, any amendments or supplements, and oral testimony constitute the necessary findings for this ordinance. Ordinance No. NS-XXX Page 4 of 4 75A-31 H. Pursuant to the California Environmental Quality Act a categorical exemption has been approved for this project. Section 2. Article XIV is added to Chapter 18 of the Santa Ana Municipal Code to read as follows: Article XIV Hookah Parlors Sec. 18-650. Purpose and Findings. The City Council finds that hookah parlors have been associated with increases in noise, loitering, public drinking, possession of illegal weapons, underage drinking, and arson; that hookah parlors exacerbate the inherently dangerous behavior of tobacco use around non-tobacco users; diminish the protection of children from exposure to smoking and tobacco while they increase the potential for minors to associate smoking and tobacco with a healthy lifestyle; and weaken the protection of the public from smoking and tobacco-related pollution; and that hookah parlors if allowed in the City would have adverse secondary effects on surrounding properties, including but not limited to lowering property values and introducing incompatible land uses to existing neighborhoods; and that in order to serve public health, safety, and welfare of the residents and businesses within the City, the declared purpose of this article is to prohibit hookah parlors as defined in this article. Sec. 18-651. Hookah Parlor Defined. (a) "Hookah parlor" shall mean any facility or location whose business operation, whether as its primary use or as an ancillary use, is denoted by the smoking of tobacco or other substances through one or more pipes (commonly known as a hookah, waterpipe, shisha or narghile) designed with a tube passing through an urn of water that cools the smoke as it is drawn through it, including but not limited to establishments known variously as hookah bars, hookah lounges or hookah cafes. (b) "Ancillary use" shall be defined as that term is defined in section 41-13.5 of the Code. Ordinance No. NS-XXX 75A-32 Page 5 of (c) "Primary use" shall mean a use that is not an ancillary use. Sec. 18-652. Hookah Parlors Prohibited. It shall be unlawful for any person or entity to own, manage, conduct, or operate any hookah parlor or to participate as an employee, contractor, agent or volunteer, or in any other manner or capacity, in any hookah parlor in the City. Section 3. Section 41-73.5 of the Santa Ana Municipal Code is hereby added to define medical hookah parlors as follows: Sec. 41-73.5. Hookah Parlors. (a) "Hookah parlor" shall mean any facility or location whose business operation, whether as its primary use or as an ancillary use, is denoted by the smoking of tobacco or other substances through one or more pipes (commonly known as a hookah, waterpipe, shisha or narghile) designed with a tube passing through an urn of water that cools the smoke as it is drawn through it, including but not limited to establishments known variously as hookah bars, hookah lounges or hookah cafes. (b) "Primary use" shall mean a use that is not an ancillary use. Section 4. Section 41-144 of the Santa Ana Municipal Code is hereby amended to prohibit hookah parlors as a retail or service use in the City such that it reads as follows (new language in bold, deleted language in strikeout for tracking purposes only): Sec. 41-144. Retail and service uses. Retail and service uses include any use of property for the purpose of offering merchandise or services to the public for compensation, and include banks, savings and loan associations, and similar financial institutions, but do not include the following: (a) Sheet metal shops, body-fender works, automobile paint shops, repair garages, and any activity which includes the processing, treatment, manufacturing, assembling or compounding of any product, other than that which is clearly Ordinance No. NS-XXX Page 6 of 4 75A-33 and traditionally incidental and essential to a particular retail activity. (b) A medical marijuana dispensary as defined in section 41-121 of this Code. (c) A hookah parlor as defined in section 41-73.5 of this Code. (sd) Any use which is more specifically identified as a permitted use or as a use which may be permitted subject to the issuance of a conditional use permit in one or more use districts pursuant to Article III of this chapter. Section 5. If any section, subsection, sentence, clause, phrase or portion of this ordinance is for any reason held to be invalid or unconstitutional by the decision of any court of competent jurisdiction, such decision shall not affect the validity of the remaining portions of this ordinance. The City Council of the City of Santa Ana hereby declares that it would have adopted this ordinance and each section, subsection, sentence, clause, phrase or portion thereof irrespective of the fact that any one or more sections, subsections, sentences, clauses, phrases, or portions be declared invalid or unconstitutional. ADOPTED this day of , 2008. Miguel A. Pulido Mayor APPROVED AS TO FORM: Joseph W. Fletcher, City Attorney By: Benjamin Kaufman Chief Assistant City Attorney Ordinance No. NS-XXX Page 7 of 75A-34 AYES: Councilmembers NOES: Councilmembers ABSTAIN: Councilmembers NOT PRESENT: Councilmembers CERTIFICATE OF ATTESTATION AND ORIGINALITY I, PATRICIA E. HEALY, Clerk of the Council, do hereby attest to and certify that the attached Ordinance No. NS-XXX to be the original ordinance adopted by the City Council of the City of Santa Ana on ,and that said ordinance was published in accordance with the Charter of the City of Santa Ana. Date: Clerk of the Council City of Santa Ana Ordinance No. NS-XXX Page 8 of 4 75A-35